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Endometrial micropolyps at fluid hysteroscopy suggest the existence of chronic endometritis
Ettore Cicinelli1, Leonardo Resta, Roberto Nicoletti
11st Department of Obstetrics and Gynaecology, University of Bari, Italy. Cicinelli@gynecology1.uniba.it
Background:
At fluid hysteroscopy the presence of endometrial micropolyps (less than 1 mm of size) is a frequent finding. Although their origin is still unknown, in our experience they are associated with stromal edema, endometrial thickening and periglandular hyperhaemia that suggest the existence of chronic endometritis. This study will aim to describe these lesions and evaluate their inflammatory significance by comparing hysteroscopic and histological findings.
Methods:
820 women underwent hysteroscopy and endometrial biopsy. Sensitivity, specificity, positive and negative predictive values and accuracy of the micropolyps presence for the diagnosis of chronic endometritis were calculated.
Results:
Micropolyps were found in 96 cases (11.7% of all hysteroscopies); in 90 (93.7%) of these cases histology confirmed the presence of chronic endometritis. In women without micropolyps, chronic endometritis was significantly less frequent (78 cases, 10.8%) (P < 0.000001). The likelihood of chronic endometritis for women with micropolyps was very high (odds ratio 124.2, confidence interval 50.3-205.4). The sensitivity, specificity, positive and negative predictive values were 54%, 99%, 94% and 89%, respectively; the diagnostic accuracy was 90%.
Conclusions:
The presence of endometrial micropolyps at fluid hysteroscopy is significantly associated with endometrial inflammation and can be considered a reliable diagnostic sign for this pathology.
Insights
Endometrial micropolyps, small growths found during fluid hysteroscopy, are strongly linked to chronic endometritis. Their presence is a reliable indicator of this common endometrial inflammation.
Area of Science:
- Gynecology
- Pathology
- Reproductive Medicine
Background:
- Endometrial micropolyps (<1 mm) are frequently observed during fluid hysteroscopy.
- Associated findings like stromal edema suggest a link to chronic endometritis.
- The exact origin of micropolyps remains unclear.
Purpose of the Study:
- To describe endometrial micropolyps.
- To evaluate their association with chronic endometritis.
- To compare hysteroscopic and histological findings.
Main Methods:
- Hysteroscopy and endometrial biopsy were performed on 820 women.
- Diagnostic values (sensitivity, specificity, predictive values, accuracy) for micropolyps in diagnosing chronic endometritis were calculated.
Main Results:
- Micropolyps were identified in 11.7% of cases (96/820).
- Histology confirmed chronic endometritis in 93.7% of women with micropolyps.
- The presence of micropolyps showed a very high odds ratio (124.2) for chronic endometritis, with high diagnostic accuracy (90%).
Conclusions:
- Endometrial micropolyps detected via fluid hysteroscopy are significantly associated with endometrial inflammation.
- Micropolyps serve as a reliable diagnostic marker for chronic endometritis.
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